Affording long-term nursing or other personal care services can be difficult for those who need these services. It may come as a surprise to some that these necessary medical services are not covered by their Medicare plans. This situation leaves many people in the position of relying on the Medicaid program to pay for this care. Without careful planning, qualifying for Medicaid can be complicated and expensive for you and your family.
Like Medicare, Medicaid is a federal program which is administered by the state where the recipient lives. This program pays for pays for certain medical services for induvial who are 65 or older, blind, or disabled. Generally, Medicaid covers both skilled care, which is commonly nursing home or rehabilitative care, and room and board. It can also include hospice care inside and outside the home and personal care services in the home.
Medicaid allows individuals to qualify while still keeping interest in a home in Michigan as well as up to $2000 in personal assets. Some assets, like your interest in your home, are excluded from being considered against you by Medicaid. However, there are numerous rules about how other personal assets will be considered under this program. The bottom line is that to qualify you are going to have minimal assets or have your assets structured in a manner which does not count against you.
Medicaid has a five-year look-back period meaning that all of your asset transfers for the last five years will be scrutinized from the date you apply for services. If it is found that you gave certain gifts, the amount of the gift will be divided in a manner which will exclude you from coverage for a specific number of months.
The assets of a couple are considered together. This raises as concern for couples where one spouse requires services while the other does not. The financial status of the couple is considered on the day the person begins Medicaid services. From there it is expected that half of the couples’ resources will be spent down in order for the person needing services to qualify. The Michigan, Community Spousal Resource Allowance allows the spouse who does not require services to retain up to $120,900 in countable assets. Anything beyond that will have to be spent for their partner to qualify for Medicaid. The minimum is $24,180 meaning that if the couple has this amount or less in applicable resources, they do not have to spend them.
The Medicaid applicant is limited to keeping $60 per month in personal income. Their spouse may keep their income, but if they make less than their partner, then they are also allowed to keep a part of their spouse’s income through a Monthly Maintenance Needs Allowance which is between approximately $2,000 and $3000 per month.
While Medicaid rules are strict, there are measures which can be taken to protect your assets. The best planning for the Medicaid process should be done early and with the advice of an experienced attorney. With careful planning, you can increase your chances of being qualified for the care you need while safeguarding your family’s assets. Our office has attorneys and other sources who are knowledgeable about Medicaid and can help you understand your choices and make informed decisions. Please contact us if we may be of assistance.